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The ANCC Certification Verification form serves as a critical document in the process of validating a candidate's educational background for Advanced Practice Registered Nurse (APRN) certification. This form requires candidates to provide personal information, including their name, contact details, and educational program specifics. Program directors play a vital role in completing the form by detailing the courses the candidate has taken and confirming the fulfillment of clinical hours. The form must be submitted in a specific manner, whether as a hard copy or electronically, to ensure timely processing. It includes sections that address the candidate's educational preparation, such as the type of degree obtained and the accreditation status of the program. Additionally, the form necessitates a statement of understanding from the program director, affirming the accuracy of the information provided. This verification is essential for the American Nurses Credentialing Center (ANCC) to assess the candidate's eligibility for certification, which ultimately impacts their professional practice and career advancement.

Ancc Certification Verification Example

Validation of APRN ￿

Education Form

APPLICANT INSTRUCTIONS

Complete: All sections of the Validation of Education Form.

Collect Required Documents for Submission:

-Unofficial/Official Transcript(s)

-Completed Validation of Education Form

-Clinical Logs reflecting clinical hours completed

Submit VOE, Unofficial Transcripts and Clinical Logs by one of the options below:

-Upload to website at time of application.

-Upload to web based ANCC portal after initial online application is complete.

-Email completed PDF attachment to [email protected].

*Official Transcripts must be sent directly from your school to ANCC

APPLICANT DEMOGRAPHICS

Last Name

First Name

 

MI

 

 

 

 

Other Legal Names Used

Email

 

 

 

 

 

 

Address

City

State

Zip/Postal

CPM-FRM-51 | Validation of APRN Education Mar 2025

EDUCATIONAL DEMOGRAPHICS

University Name

 

 

State

 

 

 

 

Faculty Program Director Name/Title­

 

Faculty Email

Faculty Phone Number

 

 

Select Applicant Degree Type

 

Select Role/Population of Education Program

 

 

 

 

 

 

APPLICANT PROGRAM TYPE

 

APPLICANT DEGREE AWARDED

 

(Degree and Program type selected above MUST match university transcripts. If post-graduate certificate is not identified as degree type on university transcript, applicant must submit a letter of attestation from university registrar on letterhead confirming degree type completed.)

DATE OF DEGREE CONFERRAL

(For applicant’s who are applying prior to graduation, select future date of anticipated degree conferral).

Select Nursing Program Accreditor at Time of Applicant’sGraduation

NURSING PROGRAM ACCREDITOR

(Indicate nursing accreditor at time of applicant’s graduation).

PROGRAM ELIGIBILITY REQUIREMENTS

Program includes content in Health Promotion/Disease Prevention.

 

 

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

Program includes content in Differential Diagnosis and Disease Management, including the use and prescription

 

YES

 

NO

of pharmacologic and nonpharmacologic interventions.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APRN CORE ELIGIBILITY REQUIREMENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Term/Year

Course

 

Course Title

Course transferred

 

 

University Name for

 

of Completion

Number

 

Must match transcript(s)

Check box

 

 

Transfer Course

 

 

 

 

 

 

 

 

 

 

 

Advanced Physical and Health

 

 

 

 

 

 

 

 

 

 

Assessment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Advanced Pathophysiology

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Advanced Pharmacology

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CLINICAL ELIGIBILITY REQUIREMENTS

Indicate total number of faculty-supervised clinical hours completed by applicant directly related to the role/population of program identified above. Please submit a copy of clinical logs with Validation of Education Form

For PMHNP applicants only. Clinical training in at least two psychotherapeutic treatment modalities.

YES

NO

ATTESTATION

I, ___________________________________________, the Applicant for Certification identified above (the “Applicant”), attest to and confirm that the

information provided in this Validation of APRN Education Form (“Form”) is true, accurate, and complete, and reflects the coursework and clinical hours actually completed by the Applicant.

•For applicants applying for Certification prior to degree conferral, this attestation confirms that all coursework and faculty-supervised clinical hours for the program and degree are complete;

•Applicant attests that the total number of faculty-supervised clinical hours do not include hours awarded for work experience or any hours other than facul- ty-supervised clinical hours in the role/population indicated on the VOE form above;

•For post-graduate certificate applicants, this attestation confirms that all transcript(s) and associated course syllabi (source documents) from the original degree program(s) were reviewed and validated by the faculty program director upon enrollment in the post-graduate certificate program. Applicant attests that the faculty program director conducted a formal gap analysis of transfer courses and has evaluated and validated that all transfer courses meet the current existing requirements for the post-graduate certificate program.

Required Applicant Signature

Printed Name

Date

ANCC reserves the right to request a more detailed accounting of educational demographics of applicants prior to continuation of application review. Requests may include, but are not limited to, the requirement to produce source documents such as course descriptions/syllabi from time applicant completed coursework. ANCC reserves the right to close applications where source documents are not provided. ANCC may contact the faculty program director with questions as needed.

CPM-FRM-51 | Validation of APRN Education Mar 2025

Click for Ancc Certification Verification File

File Breakdown

Fact Name Description
Purpose of the Form This form validates the educational background of candidates applying for APRN certification.
Candidate Responsibilities Candidates must fill out their information and provide the form to their Program Director for completion.
Program Director's Role The Program Director is responsible for entering course numbers and verifying the candidate's completed courses.
Submission Methods The completed form can be submitted as a hard copy, electronically via email, or mailed directly to ANCC.
Required Information All fields in the form must be filled out completely to avoid delays in processing the candidate's application.
Accreditation Programs must be accredited by recognized bodies such as ACEN, CCNE, or CNEA at the time of the candidate's graduation.
Completion Confirmation The form requires confirmation that the candidate has completed all necessary APRN didactic courses and clinical hours.
Legal Considerations Forms without a signature from the Program Director may incur processing delays, impacting certification examination eligibility.

Guide to Using Ancc Certification Verification

Completing the ANCC Certification Verification form is an important step in your certification journey. After you fill out your section, your Program Director will need to complete the rest of the form and sign it. Make sure to provide accurate information, as this will help streamline the process.

  1. Begin by entering your Candidate Information:
    • Last Name
    • First Name
    • Middle Initial
    • Other Legal Names Used
    • Email Address
    • City
    • State
    • Zip/Postal Code
  2. Fill out the Program Information:
    • Name of University
    • City
    • State
    • Program Director Name
    • Program Director Phone Number
    • Program Director Email
  3. Provide details about your Educational Preparation:
    • Population and Role of Program Completed (e.g., Family Nurse Practitioner)
    • Degree Type (Master’s, DNP, Post-Master’s Certificate, Post-Master’s DNP)
    • Date of (Anticipated) Completion
    • Number of Faculty-Supervised Direct, Patient Care Clinical Hours
    • Indicate if you have completed all required APRN didactic courses and clinical hours (Yes/No)
    • Accreditation of Program Completed (e.g., ACEN, CCNE, CNEA) and Expiration Date
    • Indicate if it is a Dual Program (Yes/No) and provide details if applicable
    • Complete the content sections for Health Promotion/Disease Prevention and Differential Diagnosis/Disease Management (Yes/No)
    • For PMHNP clinicians, indicate if you have content in at least 2 psychotherapeutic treatment modalities (Yes/No)
  4. After completing your section, give the form to your Program Director for them to fill in their part and sign. They will need to confirm the accuracy of the information provided.
  5. Ensure that the Program Director submits the completed form as follows:
    • Hard copy, signed, and returned to you to forward to ANCC
    • Signed electronically and emailed to [email protected]
    • Mailed to: American Nurses Credentialing Center (ANCC), Attn: Certification Registration, 8515 Georgia Avenue, Suite 400, Silver Spring, MD 20910

Get Answers on Ancc Certification Verification

What is the purpose of the ANCC Certification Verification form?

The ANCC Certification Verification form is designed to validate the educational background and clinical training of candidates seeking certification as Advanced Practice Registered Nurses (APRNs). It ensures that the candidate has completed the necessary coursework and clinical hours required for certification.

Who is responsible for completing the form?

The candidate must fill out the Candidate Information Section of the form. After this, the Program Director of the candidate's educational institution is responsible for completing the remaining sections, which include details about the program and the candidate's educational preparation.

How should the completed form be submitted?

The completed form can be submitted in several ways:

  • As a hard copy, signed by the Program Director, which the candidate will then forward to ANCC.
  • Electronically signed and emailed to [email protected] .
  • By mailing it to the American Nurses Credentialing Center (ANCC) at the specified address in Silver Spring, MD.

What information is required from the candidate?

The candidate must provide personal information such as their last name, first name, middle initial, other legal names used, email address, city, state, and zip/postal code. Additionally, they must detail their educational preparation, including the population and role of the program completed, degree type, and anticipated completion date.

What details must the Program Director include in the form?

The Program Director must include the name of the university, the city and state of the institution, their name, phone number, and email address. They also need to confirm the candidate's completion of required courses and clinical hours, as well as provide information about the program's accreditation.

What happens if the form is submitted without a signature?

If the form is submitted without the Program Director's signature, it may cause a delay in processing. This delay could impact the candidate's application review and their ability to take the certification examination.

What is required for dual programs?

If the candidate is enrolled in a dual program, the Program Director must specify the roles and populations associated with each program. Additionally, a detailed description of the content and clinical hours for each role and population must be attached, signed, and submitted on official letterhead.

What is the importance of faculty-supervised clinical hours?

Faculty-supervised direct patient care clinical hours are critical for ensuring that candidates have practical experience in their field. The form requires candidates to confirm whether they have completed all necessary clinical hours, as this is a key component of their educational preparation for certification.

Can ANCC request additional information after submission?

Yes, ANCC reserves the right to request a more detailed accounting of the coursework and programs completed by the candidate. They may also contact faculty members if there are questions regarding transcripts or other submitted materials.

Common mistakes

Filling out the ANCC Certification Verification form can be straightforward, but mistakes can lead to delays in processing. One common error is not completing the Candidate Information Section thoroughly. All fields must be filled out accurately, including the applicant's last name, first name, and any other legal names used. Omitting this information can result in confusion and slow down the verification process.

Another frequent mistake is failing to provide the correct course numbers and titles. The Program Director is responsible for entering this information, but it’s essential that they include the actual courses the candidate completed. If this section is left incomplete or filled out incorrectly, it may raise questions during the review, leading to unnecessary delays.

Some candidates overlook the requirement for a signature from the Program Director. Forms submitted without a signature will incur processing delays. It’s crucial to ensure that the form is signed before it is sent to the candidate for submission to the ANCC. This oversight can significantly impact the timeline for certification.

Lastly, candidates sometimes forget to attach necessary documentation, especially when dual programs are involved. If a candidate has completed a dual program, they must provide a detailed description of the content and clinical hours for each role and population. Missing this information can lead to additional requests from the ANCC, further prolonging the certification process.

Documents used along the form

The ANCC Certification Verification form is an essential document for candidates seeking certification as Advanced Practice Registered Nurses (APRNs). Alongside this form, several other documents are commonly required to ensure a comprehensive verification process. Below is a list of these documents, each serving a specific purpose in the certification journey.

  • Official Transcript: This document provides a complete record of the candidate's academic history, including courses taken and grades received. It is crucial for verifying educational qualifications.
  • Gap Analysis Documentation: If a candidate has completed a post-graduate program, this document outlines any prior coursework or clinical hours accepted from previous programs. It helps establish the candidate’s eligibility for certification.
  • Program Accreditation Verification: This document confirms that the candidate's educational program is accredited by a recognized body. Accreditation is essential for ensuring that the education meets industry standards.
  • Clinical Hours Documentation: This record details the candidate's faculty-supervised direct patient care clinical hours. It is necessary to demonstrate that the candidate has met the hands-on experience requirements.
  • Letter of Recommendation: A letter from a faculty member or clinical supervisor can support the candidate's application. It provides insight into the candidate’s skills and readiness for certification.
  • Identification Verification: This document, often a government-issued ID, is required to confirm the identity of the candidate. It helps prevent fraud and ensures that the correct individual is applying for certification.

Each of these documents plays a vital role in the certification process, ensuring that candidates meet the necessary educational and clinical standards. Preparing these documents in advance can streamline the application process and help candidates achieve their certification goals more efficiently.

Similar forms

  • Verification of Nursing Program Completion Form: Similar to the ANCC Certification Verification form, this document confirms that a candidate has completed the necessary educational requirements for nursing licensure. It requires information about the program, including course completion and accreditation details.
  • National Council of State Boards of Nursing (NCSBN) Verification Form: This form serves to verify a nurse's credentials and licensure status across states. Like the ANCC form, it includes sections for educational background and program director signatures.
  • State Board of Nursing Application: This application is required for obtaining a nursing license in a specific state. It asks for educational details and may require similar documentation to validate the candidate's education and clinical hours.
  • Credentialing Application for Healthcare Providers: This document is used by healthcare organizations to verify the qualifications of medical professionals. It often requires proof of education and training, mirroring the verification process in the ANCC form.
  • Continuing Education Verification Form: This form confirms that a healthcare professional has completed required continuing education courses. It shares the need for detailed course information and signatures from program directors or educators.
  • Clinical Competency Verification Form: Used in various healthcare settings, this form verifies that a candidate has met the clinical competency requirements for their role. It includes similar sections for educational background and direct supervision.
  • Residency Completion Verification Form: This document is used to verify that a candidate has completed a residency program. It requires detailed information about the program and confirmation from the residency director, paralleling the ANCC's requirements.
  • Application for Advanced Practice Registered Nurse (APRN) Licensure: This application is necessary for APRNs to obtain licensure. It includes sections for educational verification, similar to the ANCC Certification Verification form, ensuring that all educational criteria are met.

Dos and Don'ts

When filling out the ANCC Certification Verification form, there are important guidelines to follow. Here is a list of what you should and shouldn't do:

  • Do fill in all required fields accurately.
  • Do ensure that the Program Director completes the form and provides a signature.
  • Do submit the form in one of the accepted formats: hard copy, electronically signed email, or mailed copy.
  • Do attach any necessary documentation, such as a detailed description of dual programs if applicable.
  • Don't leave any fields blank; incomplete forms will cause delays.
  • Don't forget to include the actual course numbers and titles completed by the candidate.
  • Don't submit the form without the required signature from the Program Director.
  • Don't overlook the need for additional documentation if the candidate has completed a dual program.

Misconceptions

Misconceptions about the ANCC Certification Verification form can lead to confusion and delays in the certification process. Here are some common misunderstandings:

  • Only the Candidate needs to fill out the form. This is incorrect. The Candidate must complete their section, but the Program Director is responsible for filling out and signing the remainder of the form.
  • Electronic submission is not allowed. In fact, the form can be signed electronically and emailed directly to the ANCC, providing a convenient option for timely submission.
  • All courses completed do not need to be listed. The Program Director must include actual course numbers and titles that the Candidate completed. This ensures accurate validation of educational preparation.
  • The form can be submitted without a signature. This is a misconception. Forms submitted without the Program Director’s signature will incur delays in processing, affecting the Candidate's application timeline.
  • Accreditation information is optional. On the contrary, providing the accreditation status of the program is a required part of the form, ensuring that the Candidate's education meets necessary standards.
  • There is no need to specify dual programs. If the Candidate has completed a dual program, it is essential to specify the roles and populations involved and attach a detailed description of the content and clinical hours.
  • Only one type of degree is acceptable. The form accommodates various degree types, including Master’s, DNP, and Post-Master’s Certificates, as long as the appropriate documentation is provided.
  • Submitting the form is the final step in the certification process. While submission is crucial, the ANCC reserves the right to request additional information or clarification, which may be necessary for the certification review.

Key takeaways

Filling out the ANCC Certification Verification form is a crucial step in the certification process for Advanced Practice Registered Nurses (APRNs). Here are some key takeaways to ensure a smooth experience:

  • Complete Candidate Information: The candidate must fill in their personal details accurately, including last name, first name, and email address.
  • Program Director's Role: The program director is responsible for completing the remainder of the form, including course numbers and signatures.
  • Submission Options: The completed form can be submitted in three ways: as a hard copy, electronically via email, or by mail to the ANCC.
  • Accurate Course Details: Ensure that the program director includes the actual courses completed by the candidate to avoid processing delays.
  • Clinical Hours Documentation: Candidates must provide the number of faculty-supervised direct patient care clinical hours completed.
  • Signature Requirement: A signed form is essential. Forms without a signature will result in delays in processing the candidate’s application.
  • Additional Documentation: If applicable, include detailed descriptions of dual programs and any gap analysis documentation on school letterhead.
  • Review Process: ANCC may contact faculty for clarification or request further details about coursework if needed.

By following these guidelines, candidates and program directors can facilitate a more efficient certification process.